My Company

By Dan Cook

What’s the first thing U.S. medical consumers look for in a physician? Far and away, the answer is someone who listens and pays attention to them.

And when consumers want information that compares either health plans or physicians, who are they most likely to turn to? Friends and family, rather than the emerging data bases that are being created to help health care consumers make better choices for themselves.

Those are two of the big takeaways from an Associated Press-NORC Center for Public Affairs Research study of Americans and their relationship with their primary care provider. Funded by the Robert Wood Johnson Foundation, the study offers compelling insight into how Americans choose primary care providers, what they expect of them, and the role quality and affordability play in the relationship.

“Most Americans focus on the doctor-patient relationship and interactions in the doctor’s office, with fewer thinking about the effectiveness of treatments or their own health outcomes. Further, individuals report that they value provider quality over cost and are willing to pay more for higher-quality doctors, but when asked directly in the survey, few report having done so,” the study concludes.

When asked to rank the most important factors that define a high-quality primary care provider, “listens/attentive” outranked all other factors, including “accurate diagnosis/competence,” “caring,” “bedside manner,” “time with patients” and communication. Factors such as affordability, putting patients first and a physician's medical values barely registered with those surveyed.

And although those surveyed overwhelmingly said they thought doctors should offer more transparency about the outcomes of their work, very few actually took such outcomes reporting into consideration when making decisions about who to turn to for medical care.

Some survey highlights:

Consumers agree with health policy experts in principle that public reporting requirements for doctors would improve health care quality. Overwhelming majorities say requiring doctors to report the effectiveness of their treatments and patient satisfaction with care would improve the quality of care provided in the United States.

Less than a quarter of consumers are receiving provider quality information. Most people are not very confident they could find provider quality information they can trust on their own, including direct comparisons of physicians.

Respondents say they would trust word-of-mouth and personal recommendations from doctors far more than provider quality data coming from the government or third parties.

A third of respondents say it’s easy to find information they trust related to the costs of provider care. Fewer say it’s easy to find data that compares a provider’s costs and quality.

About half say they believe that higher quality health care generally comes at a higher cost, while 37 percent say there is no real relationship between quality and cost.

Despite government efforts to develop data bases and reporting systems that allow for comparisons in physician outcomes, cost of care and comparisons among providers, the survey indicated that most Americans are either unable to find such data or don’t make the effort to look for it.

Just under a quarter of those surveyed reported seeing information that offered comparisons on physician outcomes, and of those, only 11 percent said they have seen and used provider quality data. And even among that small group, most of the “information” came “from friends or family (63 percent),” with less gathered from ratings website (53 percent), or a physician (53 percent). “The smallest proportion have seen or heard information online on a government website (38 percent),” the survey said.

Thus, a significant disconnect remains between attempts to offer information to better inform medical consumers, and accessing that data by these same consumers.

“This survey shows that finding information about the costs of health care provided by different doctors is even more difficult for consumers than finding information about provider quality; finding both cost and quality information in the same place is an even greater challenge,” the survey said.